Myocarditis From Scorpion Stings

Abstract

A clinical and electrocardiographic study of 45 patients who were stung by the common scorpion of Trinidad, Tityus trinitatis (family-Buthidae) was done. Patients were examined soon after admission, and serial 12-lead electrocardiograms were done on admission and at approximately 24, 48, and 72 hours after the scorpion sting. If the e.c.g. was still abnormal at the end of 72 hours it was repeated at the end of the week. Fasting blood sugar, urinary sugar, serum amylase, serum electrolytes, and blood urea estimations were done within 24 hours of admission. The common clinical findings were pain at the site of the sting, excessive salivation, vomiting, epigastric pain, abdominal tenderness, disturbance of heart rate and rhythm, glycosuria, pyrexia, and profuse sweating. Nine patients were shocked, and 3 had muscular twitchings and carpopedal spasms. Thirty-four patients had electrocardiographic evidence of myocarditis[long dash]that is, inversion of the T waves in several leads, significant deviation of the RST segment, prolongation of Q-Tc and conduction defects with complete restoration to normal in 3 to 6 days. Toxic myocarditis has not been previously described after scorpion stings. Death is usually ascribed to a toxic effect on the medullary centers. Myocarditis is the commonest complication following stings by Tityus trinitatis, and it would be reasonable to postulate that it is a frequent cause of death in this condition.